How Bad Gums May Lead to Rheumatoid Arthritis

Gum disease and rheumatoid arthritis
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If you are wondering how bad gums could possibly hurt your joints, researchers have pondered the same question, and now they have an answer. What they discovered could help you be better prepared to fight both gum disease and the ravages of rheumatoid arthritis.

Do you have bad gums?

Gum disease, also known as periodontal disease, affects approximately 9 percent of adults ages 20 to 64 years. Symptoms of periodontal disease can range from mild to severe and include bleeding and/or inflamed gums, mouth pain, and eventual damage and destruction of the structures that support and maintain the teeth. In severe cases, individuals lose teeth.

At the University of Louisville School of Dentistry Oral Health and Systemic Diseases, a research team lead by Jan Potempa, PhD, DSc, explored the relationship between two chronic inflammatory conditions--periodontal disease and rheumatoid arthritis—and discovered that the bacterium that causes periodontal disease—Porphyromonas gingivalis—has an impact that reaches beyond the mouth.

In fact, P. gingivalis can have an impact on the joints in rheumatoid arthritis, making the disease worse in several ways. That is, the bacteria can

  • Cause rheumatoid arthritis to occur earlier
  • Cause the disease to become worse faster than usual
  • Cause greater destruction of cartilage and bone than usual

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The investigators used mouse models in the study. Specifically, the researchers discovered that P. gingivalis makes peptidylarginine deiminanse (PAD), an enzyme that enhances a type of arthritis called collagen-induced arthritis, which is similar to rheumatoid arthritis.

PAD sets off a series of events that results in the body attacking its own tissues. In people with rheumatoid arthritis, which is an autoimmune disease, the result can mean damage to cartilage and bone within the joints.

Gums and rheumatoid arthritis have a history
Previous research has shown that people with periodontal disease have an increased prevalence of rheumatoid arthritis, and that gum disease is at least twice as prevalent among rheumatoid arthritis patients than it is among the general population. In addition, several studies show that when people with both diseases are treated for one condition, they experience relief from the other disease as well.

Potempa noted that their results “suggest that bacterial PAD may constitute the mechanistic link between P. gingivalis periodontal infections and rheumatoid arthritis,” but that this new discovery will need to be researched further for verification. The findings are also an excellent reason to practice good oral hygiene and take steps to avoid or treat bad gums.

REFERENCES
Al-Katma MK et al. Control of periodontal infection reduces the severity of active rheumatoid arthritis. Journal of Clinical Rheumatology 2007; 13:134-37
De Pablo P et al. Periodontitis in systemic rheumatic diseases. National Review of Rheumatology 2009; 5:218-24
Maresz KJ et al. Porphyromona gingivalis facilitates the development and progression of destructive arthritis through its unique bacterial peptidylarginine deiminase (PAD). PLoS Pathogens 2013; 9(9): e1003627
National Institute of Dental and Craniofacial Research
Ortiz P et al. Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors. Journal of Periodontology 2009; 80: 535-40

Image: Morguefile

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